Size and Potential Problems of ObamaCare's Army of 'Navigators' Going Largely Unnoticed

If the employment numbers seem better than one might have expected during the next few months, it may have nothing to do with private companies hiring people to provide goods and services people actually want. It may instead relate to the army of paper-pushers who are being hired to help individuals and families apply for ObamaCare subsidies starting on October 1.

If California's situation is typical of what will be happening nationwide, the total number of "enrollment counselors," also known as "navigators," hired for this supposedly short-term task will be huge. In the tarnished Golden State alone, according to Judy Lin at the Associated Press, 21,000 counselors will be hired from among "an estimated 3,600 community organizations ranging from Native American tribes and chambers of commerce to labor unions and faith-based organizations that will be authorized to help people buy insurance." Project that to the entire country, and we're talking about roughly 175,000 counselors.


We're also talking about creating the mother of all soft identity-theft targets (HT Reason's Hit and Run blog; bolds are mine):

Fraud fear raised in California's health exchange

As California prepares to launch its health care exchange, consumer groups are worried the uninsured could fall victim to fraud, identity theft or other crimes at the hands of some of the very people who are supposed to help them enroll.

The exchange, known as Covered California, recently adopted rules for a network of more than 21,000 enrollment counselors who will provide consumers with in-person assistance as part of the federal Affordable Care Act. In some cases, they will have access to personal and financial information, from ID cards to medical histories.

But the state insurance commissioner and anti-fraud groups say the exchange is falling short in ensuring that the people hired as counselors are adequately screened and monitored.

Insurance Commissioner Dave Jones also said the exchange does not have a plan for investigating any complaints that might arise once the counselors start work. That means consumers who might fall prey to bogus health care products, identity theft and other abuses will have a hard time seeking justice if unscrupulous counselors get ahold of their Social Security number, bank accounts, health records or other private information, he said.

"We can have a real disaster on our hands," Jones, a Democrat, said in an interview.

His department regulates more than 300,000 insurance agents and brokers statewide.

Starting Oct. 1, the state is embarking on an ambitious effort to enroll an estimated 5.3 million Californians who lack health insurance, about half of whom will be eligible for tax credit subsidies.

... The exchange will pay an organization $58 for each successful enrollment and $25 for a renewal, but the amount the counselors receive will vary.

Note that Jones, whose hand is just a few inches away from the panic button, is a Democrat.

Also note that the capitated business model appears to create a huge temptation on the part of the organizations involved to create phantom sign-ups. What kind of controls are in place to prevent phantom sign-ups, or to detect them if they're submitted?

And they're going to get all of this done in 90 days (because sign-ups start on Oct. 1, and the individual mandate takes effect on Jan. 1, 2014)? O ... M ... G.

I checked several days ago to see if Lin's July 13 AP story was at the wire service's national site (stories over a week old often but not always disappear). It wasn't. None of the stories returned in a search there on "health insurance" at 11 p.m. ET (not in quotes) addresses the fraud or identify theft issues.

The estimated 175,000 counselors needed (again, that's based on projecting California's numbers nationwide; if that's not valid, someone needs to tell me why), if seen as one private entity, would be Number 29 on Fortune's 500 list of largest private-sector employers in 2011 (not that it's particularly relevant, but to be clear, the numbers listed represent worldwide employment).

So the government, which couldn't run a puny Cash For Clunkers program without creating a cash-flow nightmare and loses $65 billion per year to Medicare and Medicaid fraud is going to go from zero to 175,000 ObamaCare "navigators" to enroll tens of millions of people (in their dreams, but that's what they're shooting for) in 3-6 months. They've had over three years to prepare for this, and it's hard to see what they've done to get ready.

Likely outcome:

TrainwreckEcon

Of course, all of this will be a total surprise to most people because only a few reporters and bloggers whose work was mostly buried covered it.

Not that the analogy is perfect, but the press seemed awfully anxious to document initial snafus in Medicare Part D when it rolled out last decade. Of course, that was during a Republican administration, so that's to be expected.

Cross-posted at BizzyBlog.com.

Tom Blumer
Tom Blumer
Tom Blumer is a contributing editor for NewsBusters.